Stress urinary incontinence (SUI) primarily affects women, but may be common in men as well. SUI may be caused by intrinsic sphincter deficiency (ISD) or hypermobility. These conditions may occur independently or in combination. In ISD, the urinary sphincter fails to close properly, causing urine to leak out of the urethra during stressful activity. Hypermobility is a condition in which the bladder neck and proximal urethra rotate and descend in response to increases in intra-abdominal pressure (e.g., due to sneezing, coughing, laughing, etc.). As a result, the patient's response time becomes insufficient to promote urethral closure and, consequently, the patient suffers from urine leakage.
Midurethral slings are a common treatment for SUI. Midurethral slings work optimally when placed without tension, just underneath the midurethra. A plastic sheath protects the sling and allows it to be adjusted during placement. Once the midurethral sling (i.e., sling) is placed in an optimal position, the plastic sheath is removed. However, removal of the plastic sheath may cause the sling to move cephalad (i.e., towards the head or anterior end of the body) or to be pulled so that it is no longer free of tension. Removal of the sheath may also cause the sling to roll or fold which may lead to failure or irritative voiding symptoms and/or voiding dysfunction. It is with respect to these considerations and others that the various embodiments of the present invention have been made.